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PHARMACOLOGY > Antiviral Drugs (excluding HIV drugs) > Flashcards

Antiviral Drugs (excluding HIV drugs) Flashcards

1
Q

Mechanism: Sofosbuvir

A

Inhibits HCV RNA-dependent RNA polymerase acting as a chain terminator

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2
Q

Mechanism: Simeprevir

A

HCV protease inhibitor → prevents viral replication

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3
Q

When using Cidofovir, coadminister ___ and ___ to decrease nephrotoxicity

A

Probenecid

IV saline

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4
Q

Clinical use: Ribavirin

A
  1. Chronic HCV
  2. RSV (Palivizumab preferred in children)
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5
Q

Clinical use:

Oseltamivir

Zanamivir

A

Treatment and prevention of both influenza A and B

Beginning therapy within 48 hours of symptom onset may shorten duration of illness

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6
Q

Clinical use:

Acyclovir

Famciclovir

Valacyclovir

A

HSV - mucocutaneous/genital lesions, encephalitis

VZV - reduce symptoms of chickenpox (early)

Weak activity against EBV

No activity against CMV (no thymidine kinase)

VZV prophylaxis in immunocompromised patients

No effect on latent forms of HSV and VZV

Valcyclovir is a prodrug of Acyclovir (better oral F)

Herpes zoster → Famciclovir

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7
Q

Mechanism: Cidofovir

A

Preferentially inhibits viral DNA polymerase

Does not require phosphorylation by viral kinase

Long T1/2

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8
Q

Adverse effects: Cidofovir

A
  1. Nephrotoxicity (coadminister with Probenecid and IV saline to decrease toxicity)
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9
Q

Mechanism: Foscarnet

A

Inhibition:

  • Viral DNA/RNA polymerase
  • HIV reverse transcriptase

Binds pyrophosphate-binding site of enzyme

Does not require kinase activation

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10
Q

Clinical use: Simeprevir

A

Chronic HCV in combination with Ledipasvir (NS5A inhibitor)

NOT used as monotherapy

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11
Q

Adverse effects: Foscarnet

A
  1. Nephrotoxicity
  2. Electrolyte abnormalities → can lead to seizures
    • Hypo- or hypercalcemia
    • Hypo- or hyperphosphatemia
    • Hypokalemia
    • Hypomagnesemia
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12
Q

Clinical use: Sofosbuvir

A

Chronic HCV in combination with:

  • Ribavirin
  • Simeprevir
  • Ledipasvir (NS5A inhibitor)
  • +/- Peginterferon alfa

NOT used as monotherapy

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13
Q

Adverse effects: Ganciclovir

A
  1. Bone marrow suppression
    (leukopenia, neutropenia, thrombocytopenia)
  2. Renal toxicity
  3. More toxic to host enzymes than Acyclovir
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14
Q

Mechanism: Ribavirin

A

Inhibits synthesis of guanine nucleotides by competitively inhibiting inosine monophosphate dehydrogenase

Also inhibits other mechanisms involved in viral replication

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15
Q

Clinical use: Ganciclovir

A

CMV, especially in immunocompromised patients

Valganciclovir - prodrug of ganciclovir with better oral bioavailability

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16
Q

Adverse effects: Simeprevir

A
  1. Photosensitivity reactions
  2. Rash
17
Q

Mechanism of resistance:

Acyclovir

Famciclovir

Valacyclovir

A

Mutated viral thymidine kinase

18
Q

Mechanism of resistance: Ganciclovir

A

Mutated viral kinase

19
Q

Adverse effects: Interferons (alpha, beta, gamma)

A
  1. Flu-like symptoms
  2. Depression
  3. Neutropenia
  4. Myopathy
20
Q

Adverse effects: Sofosbuvir

A
  1. Fatigue
  2. Headache
  3. Nausea
21
Q

Mechanism:

Oseltamivir

Zanamivir

A

Inhibit influenza neuraminidase → decrease release of progeny virus

22
Q

Clinical use: IFN-beta

A

Multiple sclerosis

23
Q

Mechanism: Interferons (alpha, beta, gamma)

A

Glycoproteins normally synthesized by virus-infected cells, exhibiting a wide range of antiviral and antitumoral properties

24
Q

Clinical use: IFN-alpha

A
  1. Chronic hepatitis B and C
  2. Kaposi sarcoma
  3. Hairy cell leukemia
  4. Condyloma acuminatum
  5. Renal cell carcinoma
  6. Malignant melanoma
25
Q

Clinical use: Foscarnet

A
  1. CMV retinitis in immonocompromised patients when Ganciclovir fails
  2. Acyclovir-resistant HSV
26
Q

Clinical use: IFN-gamma

A

Chronic granulomatous disease

27
Q

Adverse effects:

Acyclovir

Famciclovir

Valacyclovir

A
  1. Obstructive crystalline nephropathy → acute renal failure if not adequately hydrated
  2. Neurotoxicity → delirium, tremor
28
Q

Clinical use: Cidofovir

A
  1. CMV retinitis in immunocompromised patients
  2. Acyclovir-resistant HSV
29
Q

Mechanism: Ledipasvir

A

NS5A inhibitor

30
Q

Adverse effects: Ribavirin

A
  1. Hemolytic anemia
  2. Severe teratogen
31
Q

Mechanism: Ganciclovir

A

Guanosine analog:

5’-monophosphate formed by CMV viral kinase

Triphosphate formed by host cellular kinases

Preferentially inhibits viral DNA polymerase

32
Q

Mechanism:

Acyclovir

Famciclovir

Valacyclovir

A

Guanosine analogs:

Monophosphoylated by HSV/VZV (viral) thymidine kinase and not phosphorylated in uninfected cells (fewer adverse effects)

Triphosphate formed by host cellular enzymes

Preferentially inhibit viral DNA polymerase by chain termination

33
Q

Mechanism of resistance: Foscarnet

A

Mutated DNA polymerase

PHARMACOLOGY (33 decks)

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